office of inspector general

On February 27th, administrative law judge Rick Gilpin of Texas Health and Human Services Commission issued a final order in the “credible allegation of fraud” payment hold case of Antoine Dental of Houston, fully reversing the Proposal for Decision written … Read More

In a highly unusual move, a judge working for the Texas Health and Human Services Commission last week overturned findings of an outside judge — essentially changing a finding of innocence to one of guilt. The case is particularly unusual … Read More

March 5, 2014 — A Texas judge has upheld payment holds on Medicaid payments for Houston dental clinic Antoine Dental Center (ADC), citing credible evidence of Medicaid fraud. The clinics billed about $8.1 million for orthodontic services in less than … Read More

Last September 27th, TDMR published an article concerning the fact that the Texas Health and Human Services Commission Office of the Inspector General at that time had not yet made available on its website, information on due process rights for … Read More

In 2011, state regulators announced that they were taking a giant stride toward fighting blatant insurance fraud. They said they had identified nearly four dozen dentists and orthodontists who had ripped off taxpayers by billing Medicaid tens of millions of … Read More

February 6, 2014 — Thousands of applications for orthodontic approvals under Medicaid were delayed after Texas employed a single dentist to review them. The understaffing led to dentists, not the private company reviewing the applications, being accused of fraud for … Read More

DALLAS (CN) – A healthcare administrator delayed thousands of orthodontic approvals under Medicaid by employing just one dentist to review Texas applications, such disastrous understaffing that dentists – but not the private company – were accused of fraud for working … Read More

A long time dental Medicaid provider recently sent to TDMR an old article that was written in the March/April 2005 edition of the Texas Medicaid Bulletin. It is interesting because both the Texas Medicaid and Health Partnership (TMHP) and the … Read More

January 27th, 2014, was the latest scheduled pre-trial hearing date for Jack Stick’s DWI case. Stick is the Deputy Inspector General for Enforcement for Texas HHSC-OIG who was arrested for DWI way back in September 2012. A docket search done … Read More

The operator and director of nursing of a home health agency based in Richmond, Texas, was arrested yesterday for her alleged role in a Medicare fraud scheme and a conspiracy to structure bank withdrawals. The owner and operator of the … Read More

At the beginning of December, 2013, the Health and Human Services Commission published online its budgetary figures for 2014. Included in the document are the 2012 and 2013 expenditures and metrics for the Office of the Inspector General and its … Read More

Texas State Office of Administrative Hearings judges, the Honorable Howard Seitzman and the Honorable Catherine Egan, provided their final Proposal for Decision in the case of Houston’s Antoine Dental Center to HHSC Excecutive Director Dr. Kyle Janek on Thursday. Antoine … Read More

An online docket search of the Travis County Criminal Courts shows that the pre-trial conference hearing for Jack Stick, Deputy Inspector General of Texas HHSC-OIG, on his charge of DWI has been scheduled for January 27th, 2014.

Because of a recent attempt to have YouTube remove a TDMR-produced video about the September 2012 DWI arrest of Jack Stick, a former Texas state Rep, municipal court judge and currently Texas HHSC-OIG’s Deputy Inspector General for Enforcement, TDMR committed … Read More

TDMR believes that personal attacks on individuals are unwarranted and attempts to steer a high road in dealing with Medicaid issues. But TDMR also believes that the conduct of public officials, especially those in the employ of the Texas government … Read More

Debra Jean Velasquez, of Robstown, and Sylvia Salinas Ramirez, of Driscoll, have been ordered to prison in a scheme to defraud the Texas Medicaid program through fraudulent home health billings, announced United States Attorney Kenneth Magidson along with Texas Attorney … Read More

Back on October 15th, 2012, now more than a year ago, Texas Deputy Attorney General for Civil Litigation John Scott testified before the House Committee on Public Health in the Capitol. TDMR has just reviewed the archived video from the … Read More

Update: It’s Day Two in the civil trial of District Attorney Rosemary Lehmberg. Throughout the trial’s first day, a host of witnesses testified for the prosecution, recounting the events leading to Lehmberg’s booking at the Travis County Jail and what … Read More

Before the Thanksgiving long weekend, TDMR received a copy of the August 2012 audit conducted by the HHSC Office of the Inspector General on the Texas Medicaid and Healthcare Partnership. As far as we know this is the first time … Read More

On April 1, Texas’ most powerful elected officials gathered at the state Capitol to rail against Medicaid. In a packed press conference room with protesters shouting outside the door, Republican Gov. Rick Perry, Lt. Gov. David Dewhurst, and U.S. Sens. … Read More

The Texas Sunset Commission is evaluating the state Health and Human Services Commission this coming year under its mandate to periodically review Texas state agencies for their operation and need to exist. About the Commission The Texas Legislature created the … Read More

HHSC Deputy Inspector General for Enforcement Jack Stick was arrested back in September 2012 for DWI while driving in downtown Austin. The full story on the arrest is on our website. A casual check of the online docket of the … Read More

BROWNSVILLE, Texas –– Texas spent $400 million on speech therapy for children under Medicaid last year, up 30 percent from three years ago. Speech therapists along a 76-mile stretch of Texas Highway 83, from Brownsville to Mission, collect more money … Read More

After a 40-year career, Dr. Paul Dunn is now on the verge of bankruptcy because he helped Medicaid children. In 2012, HHSC-OIG placed Dunn’s practice in Levelland under a 100% “credible allegation of fraud” payment hold for his orthodontic Medicaid … Read More

Austin: (PR Web): Two administrative law judges with the Texas State Office of Administrative Hearings (SOAH) have issued their proposal for decision in the case of Antoine Dental Center of Houston (ADC) SOAH Docket No. 529-13-0997. ADC had been placed … Read More

by Becca Aaronson, The Texas Tribune November 5, 2013 The Texas Health and Human Services Commission’s Office of Inspector General, which says that hundreds of millions of dollars have been misspent on fraudulent Medicaid orthodontic and dental claims, has lost … Read More

The Office of the Inspector General website now has a report detailing the 2012 fraud detection and recovery activity of all managed care organizations (MCOs) that participate in Texas Medicaid. Under Texas Government Code, Section 531.113, the MCOs are required … Read More

by Becca Aaronson October 15, 2013 Texans discovered nearly two years ago that the state was spending more on orthodontic claims in its Medicaid program than the other 49 states combined, but recovery of millions in purportedly misspent Medicaid money … Read More

Dr. Roque Joel Ramirez, 48, of Robstown, has been charged in a 14-count indictment for a scheme to defraud Medicare and Medicaid through fraudulent billings, amounting in $1.4 million. For the fulll story, follow the link: Local doctor arrested in … Read More

Nearly two years after news broke that Texas spent more on orthodontic claims in its Medicaid program than the other 49 states combined, the Health and Human Services Commission’s Office of Inspector General is barely knee deep in its effort … Read More

Here is the final judge’s order directing the Texas Health and Human Services Commission’s Executive Commissioner Dr. Kyle Janek and Inspector General Doug Wilson to return $1,255,195.20 to Harlingen Family Dentistry. The order can be downloaded here. AMENDED FINAL JUDGMENT … Read More

  TDMR has put together this article to give dental and other Medicaid providers some common language understanding of the provisions of Senate Bill 1803 now in force to protect their due process rights.  We have used the text of … Read More

There is very little commentary on the TDMR website in relation to the DWI arrest last September of Jack Stick, former State Rep and Bee Cave judge who is the Deputy Inspector General for Enforcement for HHSC-OIG. As his case … Read More

September 23, 2013 — A Texas judge has ordered the state to return $1.3 million that was withheld from Harlingen Family Dentistry (HFD) based on unfounded allegations of fraud on orthodontic Medicaid billings. Travis County Judge Amy Clark Meachum has … Read More

This morning the San Antonio Express published a feature article headlining the case of Harlingen Family Dentistry and Dr. Juan Villarreal and his fight against the Office of Inspector General and their “credible allegation of fraud” payment holds. Reporter Jeremy … Read More

SPECIAL TO THE EXPRESS NEWS- HARLINGEN,Tx July 30,2013- Dr. Juan Villarreal, a dentist at Harlingen Family in Harlingen Texas gets ready to check a patient at his office Tuesday July 30,2013. Photo by Delcia Lopez via In Medicaid, docs guilty … Read More

A Travis County judge has awarded more than $22,000 in legal fees to an Amarillo law firm that helped expose more than $1 million in Medicaid fraud at a local orthodontics clinic. Amarillo attorney Phil Russ, who represented three former … Read More

Harlingen Family Dentistry has won a tremendous legal victory this week. Travis County District Court Judge Amy Clark Meachum has granted HFD’s motion for a writ of mandamus to force the Office of Inspector General to return more than $1 … Read More

The Health and Human Services Commission has put online its self-report to the Sunset Commission as HHSC is coming up for review by the Commission this coming year. The link below will take you to the HHSC website where you … Read More

This past week State Office of Administrative Hearings (SOAH) Judge Roy G. Scudday ruled that Christine Ellis and her qui tam lawyers had no standing to appear in a hearing regarding an HHSC-Office of Inspector General payment hold placed on … Read More